Diver Medics Assist the NHS During 2020 COVID19 Pandemic Peak
Project DIVERT was a voluntarily (not-for-profit) initiative who’s stated aim was to provide support to the NHS’s overwhelmed critical care units in response to COVID-19 Pandemic.
The partnership consisted of:
- AMDP: Primarily Max Dubois (M.D. of AMDP) who had an excellent team behind him.
- Major General Michael von Bertele CB, OBE, FRCP, former Director General of Army Medical Services.
- Ian Hughes. Director of TRAUMA Training & former ICU manager & Army Officer with extensive ICU field hospital & aeromedical experience.
This all ultimately led to placement of 22 DMTs within the Royal Free Hospitals (London, UK) ICU, at the peak of the COVID19 Pandemic in April 2020.
We initially deployed a cohort of 10 DMT’s within 24hrs of the urgent call for help.We assisted with a rapid orientation period to the NHS & the Critical Care Department.
We immediately commenced work on the nightshift of the ICU, the situation was quite dire, the critical care facility was forced to massively expand and the once normal 1:1 patient to ICU nurse ratio, which is well established in ICU’s was unachievable, in many cases the ratio was 1:4.
The Surge Support Workers providing a vital stop-gap to bridge this acute need.
This is where the DMT’s fitted in. They provided an invaluable resource to assist the ICU nurses caring for a massively expanded population of; intubated, ventilated COVID19 patients, many of whom required major organ support with Kidney Dialysis.
All work was conducted in high level PPE.
From the first moment on shift, the DMT’s were taking part in the complex, direct observation and care of patients under the supervision of the superb ICU nursing staff.
Ian worked closely alongside the DMT’s providing a pastoral / educational role for the DMT’s and as an interface with the ICU department to demonstrate the true range of the DMT’s capabilities. AMDP provided excellent consistent logistical support.
After day 2, it was clear that the project was hugely successful, the Nursing & Medical management of the Critical Care Department were stunned at how well the DMT’s had intergraded into the unit, the request was made to deploy a 2nd cohort of DMT’s.
AMDP had a further 12 DMT’s onsite within 24hrs, a structured training program was instigated which an ICU practice educator and Ian conducted, and the guys were then processed into the NHS workforce.
Our DMT’s were now mixed between night and day shifts.
The effect it had on the morale of the NHS ICU staff was huge. One of the key comments repeatedly mentioned was the professionalism of the guys, for Ian, this was one of the key transferable skills from the offshore environment where working in a structured, organised environment where safety first is mandated.
After 8 days the DMT’s were actively involved in;
- Donning and doffing of Personal Protective Equipment (PPE) in accordance with WHO guidelines.
- Management of life support equipment on unconscious, patients who require assisted breathing.
- Blood sampling & analysis including arterial bloods.
- Fluid intake and urinary output checks.
- Direct critically ill patient care.
- Gathering of accurate medical history of physical signs, as well as ventilator observations, and managing observation chart entries.
- Actively involved in the turning (proning) of critically ill, intubated patients.
- Providing vital support to critical care nurses.
- Several were even selected to conduct PPE training of all staff entering ICU for the 1st time (this included Drs, Nurses, physios etc), this is a key transferable skill that can be disseminated back to the offshore environment as the implications of the pandemic grow.
All of this happened during the most critical period of the COVID19 peak.
On day 20 of the deployment, the ICU was now returning to the ‘new normal’. The need for a massive surge of additional workers has, thankfully abated and the DMT’s could decompress, undergo COVID19 testing and safely drift home, their efforts were universally applauded.